Arthroscopic shoulder stabilisation
Arthroscopic shoulder stabilisation is a minimally invasive surgery to treat recurrent shoulder instability.
What is shoulder stabilisation?
Shoulder stabilisation surgery is performed to tighten and repair an unstable shoulder joint. The two most common types of shoulder stabilisation surgery include:
- Bankart repair – to repair a torn labrum and ligament. Also known as labral repair surgery.
- Capsular shift procedures – to decrease and tighten the joint capsule (joint lining)
Surgeons tend to use minimally invasive arthroscopic shoulder stabilisation techniques unless your instability is severe and open surgery is required.
Arthroscopic shoulder stabilisation typically takes about an hour and can be performed on an outpatient basis. It is performed under general anaesthetic or using a nerve block injection of regional anaesthetic around your shoulder nerves.
This surgery involves inserting an arthroscope with a camera and tiny instruments through very small incisions near your shoulder joint. Your surgeon can then perform treatment which may include:
- anchoring your shoulder socket in place
- tightening a stretched capsule
- labral and ligament repair
- reattaching any loose tissue to your bone
- removing any excess tissue that is causing instability.
Physiotherapy is often necessary after surgery to help you regain flexibility and to strengthen your shoulder.
What causes shoulder instability?
Shoulder instability is a loose shoulder joint. The shoulder joint is one of the most common joints to experience instability. This is due to its shallowness that is required to allow it to be very mobile and flexible.
Dislocation can happen when your arm bone between your shoulder and your elbow (humerus) pops out of your shoulder socket. Subluxation is when your humerus partially slides in and out of place. As your humerus moves either completely or partially out of your shoulder socket, the joint components loosen, stretch, tear or detach. Once your shoulder has been out of joint once, it is more likely that it will happen again and for it to become unstable.
The main causes of shoulder instability are:
- Shoulder injury due to a fall, collision or over-stretch. Examples include when you run into something, are involved in a sporting tackle, lift something incorrectly, undergo a car crash or fall onto an outstretched hand. Injury is the most common cause of shoulder instability.
- Repeated shoulder movements – as seen in athletes who are swimmers or throwers. Over time the soft tissue stretches around your shoulder joint. It may also cause your rotator cuff muscles to weaken.
- Degenerative changes - due to wear and tear of your shoulder joint.
- Loose shoulder ligaments - some people have a genetic condition that causes looseness in their joints and predisposes them to develop shoulder instability.
- Repeated voluntary dislocation – such as a party trick. If repeatedly performed it can eventually happen during everyday activities especially in people who have lax joints.
Do you need surgery for shoulder instability?
Whether you need surgery for shoulder instability will depend on a number of things. These include:
- Your age
- How long you have had an unstable shoulder
- The extent of damage to your shoulder joint
- If there is damage to your muscles or nerves
- Your lifestyle and the sporting activities that you wish to continue to enjoy.
People under 30 years who enjoy sports usually need shoulder stabilisation surgery. More sedentary adults often choose to modify their sport or lifestyle. Older patients may also have an associated rotator cuff tear, which needs surgical repair.
Sometimes physiotherapy alone is enough to stabilise your shoulder. Physiotherapy aims to help restore stability and strength in your shoulder. It helps train your rotator cuff and other shoulder muscles to do the work that the damaged parts of your shoulder would normally do.
How long does it take to recover from torn labrum shoulder surgery?
Recovery from torn labrum shoulder surgery (Bankart Repair) can vary depending on the extent of your shoulder damage, where the tear was located, and your physical health before your operation. A full recovery typically takes several months.
Most patients can return to their previous level of sports with no or few restrictions and enjoy full function of their shoulder after labral repair surgery. Physiotherapy can be very effective in restoring flexibility and strength to your shoulder.